最大化阴唇整形术的安全性并优化其效果：一项系统综述与荟萃分析
Maximizing Safety and Optimizing Outcomes of Labiaplasty: A Systematic Review and Meta-Analysis.
作者信息
Escandón Joseph M, Duarte-Bateman Daniela, Bustos Valeria P, Escandón Lauren, Mantilla-Rivas Esperanza, Mascaro-Pankova Andres, Ciudad Pedro, Langstein Howard N, Manrique Oscar J
机构信息
From the Division of Plastic and Reconstructive Surgery, Strong Memorial Hospital, University of Rochester Medical Center; Cleveland Clinic Lerner Research Institute; Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School; Universidad El Bosque, School of Medicine; Department of Plastic and Reconstructive Surgery, Children's National Hospital; Department of Plastic and Reconstructive Surgery, Cleveland Clinic Florida; and Department of Plastic, Reconstructive and Burn Surgery, Arzobispo Loayza National Hospital.
出版信息
Plast Reconstr Surg. 2022 Oct 1;150(4):776e-788e. doi: 10.1097/PRS.0000000000009552. Epub 2022 Jul 26.
BACKGROUND
The considerable increase in labiaplasty requires plastic surgeons to be acquainted with the surgical techniques, their respective complications, and satisfaction rates. The authors conducted a systematic review of the available evidence on labia minoraplasty, looking at surgical techniques, clinical outcomes, and patient satisfaction.
METHODS
A comprehensive search across PubMed, Web of Science, SCOPUS, and CochraneCENTRAL was performed through October of 2020. A random-effects model meta-analysis was performed to assess satisfaction and complication rates.
RESULTS
Forty-six studies including 3804 patients fulfilled the inclusion criteria. The pooled satisfaction rate after labia minoraplasty was 99 percent (95 percent CI, 97 to 99 percent). Substantial heterogeneity was present across studies ( I2 = 63.09 percent; p < 0.001). The highest pooled incidence of dehiscence was reported for laser-assisted labiaplasty (5 percent; 95 percent CI, 2 to 8 percent) and wedge resection (3 percent; 95 percent CI, 1 to 5 perecent). The highest pooled incidence of hematoma formation (8 percent; 95 percent CI, <1 to 23 percent) and postoperative bleeding (2 percent; 95 percent CI, <1 to 15 percent) was reported for W-shape resection. The highest pooled incidence of transient pain or discomfort was reported for de-epithelialization (2 percent; 95 percent CI, <1 to 23 percent) and W-shape resection (2 percent; 95 percent CI, <1 to 15 percent). Three cases of flap necrosis were reported; two occurred using wedge resection labia minoraplasty and one was not specified. The most common causes for revision surgery ( n = 169) were dehiscence and aesthetic concerns.
CONCLUSIONS
Labia minoraplasty is a safe procedure, but serious complications requiring surgical management have been reported. Surgical experience, knowledge of female genital anatomy, and thorough technique selection in accordance with the patient characteristics are mandatory.
背景
阴唇整形手术数量显著增加，这就要求整形外科医生熟悉手术技术、各自的并发症及满意率。作者对有关小阴唇整形术的现有证据进行了系统评价，观察手术技术、临床结果及患者满意度。
方法
截至2020年10月，在PubMed、科学网、Scopus和Cochrane CENTRAL数据库进行了全面检索。采用随机效应模型进行荟萃分析，以评估满意率和并发症发生率。
结果
46项研究共纳入3804例患者，符合纳入标准。小阴唇整形术后的合并满意率为99%（95%CI，97%至99%）。各研究之间存在显著异质性（I2 = 63.09%；p < 0.001）。激光辅助阴唇整形术的裂开合并发生率最高（5%；95%CI，2%至8%），楔形切除术次之（3%；95%CI，1%至5%）。W形切除术的血肿形成合并发生率最高（8%；95%CI，<1%至23%），术后出血合并发生率最高（2%；95%CI，<1%至15%）。脱上皮术的短暂疼痛或不适合并发生率最高（2%；95%CI，<1%至23%），W形切除术次之（2%；95%CI，<1%至15%）。报告了3例皮瓣坏死；2例发生在楔形切除小阴唇整形术中，1例未明确说明。修复手术最常见的原因（n = 169）是裂开和美观问题。
结论
小阴唇整形术是一种安全的手术，但有报道称出现了需要手术处理的严重并发症。手术经验、女性生殖解剖知识以及根据患者特征进行全面的技术选择是必不可少的。
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